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This week I stayed in Madurai and took some much needed rest after nearly two weeks of traveling. So on my Sunday off this week I walked around town and checked out the local sights, some for the first time during the day! See the pictures that I took on along the way in the gallery below. It was nice to relax a bit as the pace of progress in the lab has quickly picked back up. I’m happy to report that I’ve had a good results in my experiments this week too!

In other news, Christmas in Madurai was a success! A few of my coworkers brought treats to the lab, and I managed to procure a special cake from a local bakery (see photo). Despite working a full day, and attending two lectures, it still felt like a holiday! The lab-mates came over to my apartment after work for a small celebration. I even agreed to have Henna on my hands… Santa Claus on the right and a Christmas Tree on the left, with candy canes on my fingers… hopefully its not too noticeable! Haha.

As for the party at my apartment, my friends who had the means to cook at home did so, while the others showed up with snacks from local shops. It was certainly a merry Christmas as there were more than 15 of us playing games and laughing together. I can’t say that I didn’t miss home, but this was as good as Christmas gets in a land of festivals.

I’m back in Tamil Nadu after spending ten days on winter vacation. I split my time between Singapore and Bangkok, visiting with friends Shauna and Jared from Kansas. Within the first few days of being back I saw a buccal stem cell transplant (even got to follow up today!), presented my data at lab meeting with Dr. VRM, and gave a lecture to students in the lab preparing for their national CSIR exam. A very productive week so far! The patient who got his stem cell transplant had previously undergone surgery for his acid burn, received at the workplace, which was unsuccessful. This attempt was potentially his last hope for vision in his blinded eye.

I haven’t posted an entry since I went on vacation, so I’ll write a bit about my overseas experience. By the way, Fulbrighters are allowed two weeks outside of India during the duration of the nine month grant, and now I’ve used up ten days! Anyway, I first rode eight hours by overnight train from Madurai to reach Chennai, which is where I caught my flight to Singapore. The flight was nice, cheap, and only four hours long!

It was great to see friends from back home. We took in all the sights of Singapore, like the Night Safari at the Singapore Zoo (where you can even have Doctor Fish nibble on your toes!), and several of the Singapore Museums. I was especially interested in the South East Asia civilizations museum, which had an extensive exhibit on India, with drawings from the 18th century of the Meenakshi Temple in Madurai! It was amazing to see such a great preservation, something I haven’t seen yet in India. It was very educational as well; apparently the Indians established what we call the Arabic system of numbering, along with plenty of other interesting firsts! “We owe a lot to the Indians, who taught us how to count, without which no worthwhile scientific discovery could have been made.”
–Albert Einstein

I think the thing we all enjoyed most was the food, which was well priced, although not cheaper than in India, and tasty! The other thing that made Singapore a lot of fun is the fact that there is a large population of Indians there, especially natives of Tamil Nadu. In fact, some of the first rulers of this Island nation were of Indian origin. It was nice that I got to keep my Tamil skills polished while I was away… even if it can barely get me around, it usually at least gets a smile!

I also made it to Bangkok, which was in doubt due to recent protests at the airport. It did seem like there were less tourists there because of recent events, if for no other reason than the fact that my hostel lobby was always nearly vacant! In a way that was good news for me because the volunteer guides were happy to go with me to explore the city. I went to the major tourist destinations like the Grand Palace, Temple of the Dawn, and Buddha monuments. It was great to take water taxi rides too. It may be the fastest way to get around Bangkok, considering the massive traffic congestion.

Overall, I have had a great past two weeks and am looking forward to the next two, which will involve a lot of catching up work in the lab as well as some small celebrations for Christmas, my birthday, and New Years. Merry Christmas everyone!

Fortunately I was far away from the terrorist attacks which recently hit Mumbai, and there were no safety issues for me in Madurai. There was some progress to report in the this week; I finally got my PCR product for making my In Situ Hybridization probe. Its good news as it means we can begin experiments that brought me to Aravind! Hopefully we can have some data collected by late December or early January… It would be nice to have something to talk about at the upcoming Asia ARVO conference.

The most interesting thing that happened this weekend was my visit the Dayspring Home, a one and a half hour journey from Madurai. I learned about this orphanage for children whose parents are infected with HIV through a friend that I met on my Pondicherry trip, Zoe. She is working to establish a trust and increase grant funding of the facility as well as spending quality time with the children. There are 24 children staying at Dayspring Home now (fourteen boys and ten girls).

On the way we faced some obstacles, such at the bus breaking down and having to wait on the side of the road for another one… things in India do seem to work out in the end. It was great to spend a day with the children there. We bought books (coloring, English lessons, etc.) and fruits to give the children, and played games with them. My favorite was cricket, which we played with a coconut tree branch and crate. Each time I managed to hit the ball I dropped the bat and ran, much to the amusement of the children!

Knowing that I’m a medical student, Zoe had me look at some of the children who were injured or sick. One boy had a case of impetigo and one of the girls had a sprained wrist. Fortunately we had the topical Mupirocin the boy needed for treatment of his rash… I wonder how often children like this go without any treatment at all. Anyway, I was happy to lend some medical knowledge, although I obviously still have a lot to learn! Zoe commented that it was great for the boys to have a male around for once, and a group of us in the lab are planning to visit again soon.

This week I got some rare American interaction when fellow Fulbrighter, Henry, visited me in Madurai. His project is on the genetics of camel breeding, an easy topic to make conversation about! Henry’s Indian home is in Rajisthan, but he was visiting southern India to attend another friend’s wedding. As he was so far from home anyway, I guess he wanted to make it all the way to the southern tip of India, Kanyakumari, which is only four hours away for me. One can see both sunrise and sunset over the sea… three seas meet in Kanyakumari, the Indian Ocean, Bay of Bengal, and Arabian Sea.

So we met at the Land’s End of India; there are a few interesting things there, like the Thiruvalluvar statue, and the Vivekananda. We also enjoyed walking around town and checking out the shoreline. Unfortunately for us, the locals prefer to use the beach as a toilet rather than for sun bathing or picnicking! There is also a government museum in Kanyakumari, but after through examination, which took less than an hour, its probably not worth the 100 rupees they charge foreigners (5 rupees for Indians).

This weekend I made a trip to a famous Hindu pilgrimage site called Rameshwaram. It is a three hour drive from Madurai, so I took a bus early in the morning and returned in the evening of the same day. Since it is not an especially auspicious time to visit (i.e. no festivals, etc.) I had to travel alone this time; but as I had discovered early in my experience in India, making friends is easy here, and by the time our trip was over I had made several new ones, despite the fact that we could barely communicate in English or Tamil! On the other hand, my Tamil is slowly improving, and I am understood now when I say “How are you?” and some other basic phrases.

The most famous place in Rameshwaram is the Temple, of course! Of note, the temple has long corridors with pillars along the way, and wells of water that each has their own taste. With my medical background, and microbiology knowledge, I was skeptical about trying the water… so I will have to take their word for it!

The location of Rameshwaram is significant, as it is an island off the east coast of India that is very close to the Island of Sri Lanka (about 40 km). On a clear day, and from high points in Rameswharam, you can see Sri Lanka. Between the two islands is a coral reef which is shallow and believed by legend to have been made by Ram in his attempt make a bridge so as to rescue his wife (Sita) from kidnappers (Ravana) in Sri Lanka.

The beach is also famous, and there were many people on the beach having poojas and wading around. One other interesting thing about Ramesharam is that they have rocks which (for some reason lost in translation) float. They are kept under a metal grid, but you can stick your hand through and touch them, sure enough, they feel like real rocks. I was expecting Styrofoam! The scientist in me couldÂ not accept that these rocks were denser than water, but it was an interesting sight none the less.

I’m happy to report that things with my research project are going well; I have had success isolating RNA and with my globe dissections. Soon enough I will have the probes for my in situ hybridization experimentsÂ ready and working. I am hopeful that aÂ few small steps every day will eventually add up to big results…

Perhaps more interesting was our trip last weekend to Kodaikanal. It is a four hour drive to the hill station, which is a great place to go to beat the heat of Madurai (it is 86 degrees Fahrenheit at 8 PM, as I am writing this). This is the off season though, as it starts to get very hot in late February and early March. I remember reading about the climate in Madurai before I left the States… “the summer can best be described as extremely hot, while the winter is slightly less hot.” How true that is. I guess that is why the hill stations in Southern India are so popular…

Seven of us left work in the afternoon on Saturday for our trip up into the mountains. The road leading up to Kodaikanal is probably the most windy road I have ever been on, and almost half of our group was sick between the trip up and down the mountain! No worries though because the climate and views from the mountains were amazing and well worth the traveling we had to do to get there.

We stayed overnight at a hotel in Kodai, playing games, and making some up too. We got going early the next morning, but we really didn’t have much of a choice as there was only hot water from 7 to 9 AM. I am happy to report that I finally have a somewhat functional knowledge South Indian foods, and proudly made my own order of Dosa and Idli for breakfast. Most of the day we spent going from place to place via tour bus, visiting a 500 foot deep cave, suicide point, Kodai lake, waterfalls, etc. At the end of all that we went down near the lake where they have boating, cycling, and horseback riding too.

This week I went to an Aravind eye camp, continued my research with some eye dissections, and celebrated Halloween by dressing up in a Vesti and Kurta. The eye camp was organized in a temple only about seven kilometers away from the hospital, in Thirupparankundram. There were hundreds of patients, and only three resident ophthalmologists, who managed to see every patient at twice (pre- and post- refraction, intra-ocular pressure test, etc.). Some of the patients had cataracts that were so advanced and opaque that you could almost see it from across the room. The doctors were good about showing me interesting cases, and in the end I learned how to diagnose several different types of eye pathology. I even got some practice with my ophthalmoscope. The problem of language still persists, as my Tamil is slooooowwwly progressing, and therefore I was only observing this time. The organization of the camp was impressive, the sisters (Tamil word for this is Thangachi) taking care of the basic tests like refraction, and was efficient in seeing and caring for many patients.

Things are going well in the lab. This week I dissected three globes (eyeballs) to begin the RNA extraction portion of my experiments. The eyes that were donated were useless for cornea transplantation because of poor endothelium, but fortunately still useful for research. From them I collected cells from the limbal area to continue my experiments in identifying stem cells, which I hope will lead to improved therapeutics in the future…

One of the highlights of this week was Halloween. I had to explain what it was to many of my labmates, but I think anyone can appreciate a celebration that involves sweets and interesting costumes! I also think they were impressed in the evening when I dressed up in traditional Indian garb, the top is northern Indian kurta, and the skirt on the bottom is formal wear from the south, a vesti (see below). I might have to pull this outfit back out at the next festival time!

More hiking and a weekend away… Two weekends ago Sushil, Ashwini, and I went for a hike on our Sunday off. Traveling about 20 km from Madurai yet another temple that is over 2000 years old. Alagarkoil is a temple to Vishnu that is located on a forested hillside. It seems the supply of ancient temples and hillsides is endless, and as usual, monkeys provided additional entertainment while we hiked.

A break from the noise and chaos of Madurai was in order, and as this Monday was Diwali, I thought it would be perfect timing to make a trip to a Tamil Nadu city with heritage from its French colonial days. Puducherry (a.k.a. Pondicherry). I took the overnight was an eight hour trip from Madurai to Pondicherry, made slightly less painful with the company of two English girls (Zoe and Amy) on the same trip. Little did I know, the idea of a sleeper coach is slightly deceptive. The road was bumpy and there were several times the driver laid on the horn and swerved suddenly. The Indians must be used to it, but none of the westerners sat at the back of the bus got any sleep!

Arriving in Pondicherry early Saturday morning, I briefly refreshed and went to the Aravind Hospital branch there. This is the newest addition to the Aravind system, built in 2003. There are 600 beds, the hospital is located on 20 acres of land and is 200,000 square feet of space. Renjith, the Manager of Outpatient Services, took me on a tour of the hospital. It is clear that much emphasis is placed on high-output and efficiency, a good reason why Aravind is a case study for the Harvard Business School. We went from step one, when the patient enters the hospital, through all the necessary screening, and on to the operating theaters of the largest specialty hospital in Asia.

I also got to meet with Dr. Venkatesh, who had kindly invited me to visit Aravind Pondy. We talked about what there is to see and do in Pondicherry and he asked if I would like one of the residents I met in the operating theater to show me around that evening. Of course I was happy to meet up with Sunny, who showed me around Pondicherry that evening and took me for dinner at a local French restaurant, Rendezvous. It was surely the best food that I’ve had in months. As a resident, he also had some interesting insights into the differences between American and Indian systems of training as well as a brilliant quote: “There are bumps in the road and bumps in life; here in India we are used to them, dealing with bumps comes naturally to us.”

The next day I got up early to meet the Britts for breakfast and a little tour of Pondicherry and a couple museums. There is not a lot to see in the main Pondicherry museum, but it is interesting to learn about all of the various cultural influences (i.e. Greek, Roman, French, etc.) that have touched this coastal city over the years. We also found out that most of Auroville would be open that day, but not during the Diwali celebration on Monday.

So I headed over to the “Universal City”, Auroville. It is an interesting enclave that is dedicated to unity and peace. The most interesting thing I found there was the Matrimander, a sphere with gold disks covering it, which is reminiscent of the Epcot center in Florida. You need to make an appointment to go inside, which Renjith from Aravind helped me out with, and it was definitely worth it. There is a spiral staircase around the lower half leading to the upper chamber. That room is for meditation, and is lighted with a beam of light focused on a huge crystal ball in the middle of the room. Interesting…

I spent my last day in Pondicherry exploring the town. The beach on the Bay of Bengal was beautiful, but you can’t swim on the main beach because of the rocks. However, the Auroville beach is nice and saw plenty of people enjoying the water there.. I also went over to the Sri Aurobindo Ashram, Gandhi Statue on the beach, and the School for Perfect Eyesight. Besides the constant bombardment of fire crackers for Diwali, many of which are more like bombs than the blackcats that I remember back home, it was a nice, relaxing weekend.

With the monsoon season (September – November) in full swing, this last week has been a little more relaxed and slow paced than the previous ones. Thanks to a package from mom, I was able to make pancakes with home made raspberry jam for my friends Verma and Ashwini for brunch on Sunday morning. Later in the day we took our new friend Ankoor (the MEEI resident I met last week) sight seeing to Thirumalai Nayak Palace. The building was amazing, especially the pillars (58 feet tall and 5 feet in diameter).See the picture below for some perspective!

Most of the palace is under reconstruction and really not much to look at, but there is also an adjacent museum with lots of cool sculptures and other ancient ancient artifacts. Outside we decided to take a walk around the palace grounds, where we found a group of children who for some reason were thrilled to see me, maybe they thought I was famous. Anyway, it made for some good laughs and you can see the picture below too!

Early this Wednesday morning I saw Dr. Prajna do six cataract surgeries and a pterygium removal with conjunctiva transplant. All the surgeries were different, in one case I observed a Manual Small Incision Cataract Surgery, which is done without the use of the expensive phacoemulsification machine. Dr. Prajna dexterously removed the lens and replaced it with a solid implant within 10 minutes! After the surgery was over, he told me that it is really the great results that bring patients to Aravind. Former president Dr. APJ Abdul Kalam comes here for his care, and at least one patient that I saw that day had come from Chennai (8 hours by train) to have his operation at Aravind. Another bonus of getting up early was that the chief of cornea surgery invited me to stop by anytime to see some LASIK or cornea transplantation surgeries, which I will definitely take him up on.

This week was also Dr. VRM’s birthday, so the evening before we went on a little shopping trip to buy him a cake and gift. I thought I was just there for moral support, but ended up deciding on the birthday cake and coming up with a design for it! We also made a trip to Pudumandabam market where there are hundreds of shops covered by a high stone ceiling. It is right across the road from the Meenakshi temple (and considered part of the complex which dates back to 600 BC). You must haggle here, and one of the shop attendants informed me that she frankly doubles the price for any foreigner. That’s not a surprise, but definitely helps to have Tamil friends!

At the birthday party Dr. VRM cut the cake and looked around for the oldest person in the room, that person receives the first slice. That’s a new tradition for me, but singing the old “happy birthday” tune was the same here as everywhere else. As were the people, won’t say who, sneaking frosting from the plate afterwards!

It has been another inspiring week at Aravind. Dr. VRM was in the Hindu Times recently. He also asked me to present my work and project proposal in our weekly lab meeting. I always feel a little anxious talking about my work to a large group, but it went off quite well, and I our discussion afterwards was helpful in making concrete decisions about my next steps to move the project forward. Now I need to start some delicate RNA isolation work.

One of the interesting events of the week was the celebration of the goddess Sarasvathi. She is the goddess of education. In the hospital there were several pujas, where items such as pipettes and books (in our lab) were given blessings. In the outside corridor of the operation theater, the microscopes and phacoemulsificationequipment was blessed. These ceremonies involve some prayers with burning of incense and finally a treat passed around. They also pass around some chalk dust in different colors (which I don’t know the meaning of yet) that is to be placed in a dot above the forehead. My understanding of the purpose of this is that it is to cover your third eye orÂ chakra emanating from the forehead to minimize distraction.

For the Seriasvathi celebration there was also a special event in the hostel. It is the one time each year where girls are allowed to enter the boys hostel for dancing. There was another American at this event, a fourth year ophthalmology resident from Massachusetts Eye and Ear Infirmary who is at Aravind for an elective rotation from the Harvard program. Some of my lab mates were also there, and we joined in the fun. It reminded me of a middle school dance, where the guys are wallflowers while the girls dance, but eventually everyone got into it and we had a nice time.

Four of us from the lab spent our Saturday afternoon hiking up Tirupparankundram (just try pronouncing that!). It is a giant rock outside the city that reminds me of the pictures I have seen of Ayers rock in Australia. There are some proper steps up the hill, but many of the steps are divots carved into the rock face itself. Along the way we spotted dozens of monkeys. They don’t seem to be intimidated by humans at all, as they will come close enough to touch, and my friends advised me to keep a tight grip on my belongings as they are known to snatch things, especially food, from people.

The best part of the trip was the truly spectacular view from the top. We could see all of the city of Madurai and the surrounding mountains, rock formations, rice paddies, and coconut trees. The closest comparison to areas I have been in the united states is the rock formations of the southwest, or maybe the red rocks in Denver. I’ll post some pictures, but as I noticed while I was taking them, it is really impossible to capture the beauty of a place like this in photographs.

As we reached the top the weather took a turn for the worse and it started pouring down rain. Fortunately, we found an Islamic holy place at the top for shelter. The men and women were dressed in burkas and white caps, which is otherwise rarely seen in Madurai. One of the temple priests told us that a pious Muslim is said to have stopped a massive rock from falling in this place and it has remained there since that time. They didn’t let the others from my group go into the sacred area of the temple, but for some reason they let me in to see the rock and the men praying inside the grotto. After about an hour the rain let up and we went on our journey home.